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Acellular Hemoglobin-Based Oxygen Carrier Induced Vasoactivity: A Brief Review of Potential Pharmacologic Remedies

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Hemoglobin-Based Oxygen Carriers as Red Cell Substitutes and Oxygen Therapeutics

Abstract

Hemoglobin-based oxygen carriers (HBOCs) are currently in late phase clinical development as potential red blood cell substitutes. However, in recent clinical trials, most HBOC products have elicited vasoconstriction and blood pressure elevation. Mechanisms of the HBOC-mediated vasoactivity have not been fully elucidated. However, regardless of mechanisms involved, observations from preclinical and clinical studies indicate that the HBOC-mediated vasoconstriction/blood pressure elevation can be attenuated by conventional and newer anti-hypertensive agents and vasodilators. These include calcium channel blockers, nitrovasodilators, ACE inhibitors, selective PDE inhibitors and inhalation of gaseous NO or nebulized nitrites. There is little information available regarding the safety and effectiveness of these agents when used for treatment of HBOC-mediated vasoconstriction and BP elevation. In this review we identify some potentially useful pharmacologic agents and discuss potential issues involved in their use with HBOCs.

This article was previously published in the Artificial Blood (Japan). Reproduced with permission from the Japanese Society of Blood Substitutes.

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  1. Department of Molecular Pharmacology, Physiology and Biotechnology, Brown University, 171 Meeting Street, Box G-B3, Providence, RI, 02912, USA

    Hae Won Kim & Chi-Ming Hai

  2. Department of Surgery, Brown University, Providence, RI, 02912, USA

    A. Gerson Greenburg

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  1. Brown University, Barrington, Rhode Island, USA

    Hae Won Kim

  2. Brown University, Barrington, Rhode Island, USA

    A. Gerson Greenburg

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Kim, H.W., Hai, CM., Greenburg, A.G. (2013). Acellular Hemoglobin-Based Oxygen Carrier Induced Vasoactivity: A Brief Review of Potential Pharmacologic Remedies. In: Kim, H., Greenburg, A. (eds) Hemoglobin-Based Oxygen Carriers as Red Cell Substitutes and Oxygen Therapeutics. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40717-8_38

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